HomeMy WebLinkAbout4107 Mount Vernon Ct - Applications/Reroof - 08/06/2014Aug 06 14 01:55p Severe Weather Roofing
970-223-3383 pA
l"F6rt Collins
`—
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970.416-2740 Fax 22+6134
OVER-THE-COUNTER PERMITS ONLY
This application Is to be used to apply for the following permits only (check all that apply). ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ %Meter Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # P) A C S J a-j Date 8/6/2014 7 (-( a . L4
For o//kr use only
Job Site Address (required)
Value of Consbwffon (labor, materials, profit)
4107 Mount Vemon Ct.
$3400
Property Owner Name Address
City/State Zip
Phone
Patrick Slade 4107 Mount Vernon
Ct. Fort Collins CO 80528
970-402-0740
Applicant Name Address
CIWState Zip
Phone
John Anderson PO Box 2207
Fort Collins CO 80522
970-223-2455
Contractor Address
City/State Zip
Phone
Severe Weather Roofing PO Box 2207
Fort Collins CO 80522
970-223-2455
Contractor City of Ft. Collins Sales lax #
Are you paying taxes here or by report?
Here ❑ Report
safes taenwnberis,equkedbyascanbac&*ox
Are you paying with your trust account? O Yes ❑ NO
50255
Is this a residential or mercial project? lff Residential ❑ Commercial
If residential, Is It: ngle Family Detached ❑ Condo/townhorne (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ HotelJMotel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building SO years of age or more? ❑ Yes O No lfyes, you may need to contact Historic Preservadon
If this is for a detmolitiion permit, what year was the building constrtttte ?
Ifprtor to 1975, you will need an asbestos assessment to submit MM Mis appheabm
Description of work Remove 34 asphalt shingles to decking and replace with 34 asiahalt shingles to
*If lawn sprinkler/backfiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: L& clue company name or Oty of Fr CollIns license 0
Electrician Plumber Mechanical Roofer Other
I hereby acknowledge that I have read this appll at m and State that the above information is complete and correct. I agree to
comply with all requirements contained herein and city ordinances and state laws regulating bulldirg construction. I know that a
permit Is not valid until it has been paid and issued.
PrintNam: John Anderson S19nab m / �! Date W6114